Individual
JOHN RICHARD BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 SISTER PIERRE DR, STE 201, TOWSON, MD 21204-7525
(410) 321-0284
(410) 321-0286
Mailing address
120 SISTER PIERRE DR, STE 201, TOWSON, MD 21204-7525
(410) 321-0284
(410) 321-0286
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
D0028727
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26692-1800
—
MD
Enumeration date
05/28/2005
Last updated
05/19/2010
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